HOPE Family Health is a faith-based nonprofit health center passionately devoted to extending primary, mental health, dental and pharmacy services to those left out by the traditional healthcare system. Founded in 2005, HOPE now has over 1200 patient encounters per month. Our mission is “to improve access to primary health-care in rural Middle Tennessee, with an emphasis on vulnerable populations including the uninsured, under-insured, poor, homeless, children, migrant workers, and those addicted to substances. We seek to restore dignity, faith, HOPE, and health in those we serve by making them partners in the healing process and providing them with loving, compassionate care.”

Our desire is to serve the whole person-mind, body, and spirit-while honoring the dignity and potential of every patient we see. This calling informs every decision we make as an organization and has led us to broaden our services dramatically over the last few years. We find great fulfillment in the confidence and trust of our patients and the improved quality of life so many enjoy with our support.

Leadership

CEO/Executive DirectorMrs. Jennifer G Dittes PA-C

Board ChairMr Mark L. Beeler

Board Chair Company AffiliationPresident, Beeler Enterprises

History & Background

Year of Incorporation2005

Organization's type of tax exempt status501-C3

Financial Summary

Graph: Expense Breakdown Graph - All Years

Projected Expenses$4,730,623.00

Projected Annual Revenue$4,730,623.00 (2017)

Statements

Mission

HOPE Family Health is a faith-based nonprofit health center passionately devoted to extending primary, mental health, dental and pharmacy services to those left out by the traditional healthcare system. Founded in 2005, HOPE now has over 1200 patient encounters per month. Our mission is “to improve access to primary health-care in rural Middle Tennessee, with an emphasis on vulnerable populations including the uninsured, under-insured, poor, homeless, children, migrant workers, and those addicted to substances. We seek to restore dignity, faith, HOPE, and health in those we serve by making them partners in the healing process and providing them with loving, compassionate care.”

Our desire is to serve the whole person-mind, body, and spirit-while honoring the dignity and potential of every patient we see. This calling informs every decision we make as an organization and has led us to broaden our services dramatically over the last few years. We find great fulfillment in the confidence and trust of our patients and the improved quality of life so many enjoy with our support.

Background

Like many nonprofits, HOPE was created to meet an acute need in a beloved community. In the summer of 2004, two mid-level providers working in the Westmoreland area began to discuss the idea of starting a completely different kind of clinic-one where patients were treated based on their need for care instead of their ability to pay. The area was medically underserved, geographically isolated, and struggling with pervasive poverty, sparse health insurance coverage, and a high incidence of chronic illness. The desire to care for patients who were falling between the cracks, to validate the dignity & potential of each person receiving care, and to restore hope as well as health led practitioners Jennifer Dittes & Mary Linville to open the doors of Hope Family Health in January of 2005.

The 1st year brought rewards as well as challenges. The office started out in a little double-wide-mobile home-turned-clinic filled with people, employees, donated furniture & charts. The need was undeniable & unrelenting; patients just kept coming, often having delayed care to the point of crisis. Prayer for spiritual, emotional & financial sustenance was a daily practice. The grace of God and the generous support of individuals, congregations & local foundations literally kept HOPE alive. (This is still true today!) No fancy equipment was available, but our team's commitment & heart held strong. Our relationships with our patients and their sheer faith in our abilities convinced us that love, respect & compassion were (and are!) immeasurably more important in the healing process than state-of-the-art equipment or facilities. This trial by fire assured the founders & staff that they possessed the flexibility, devotion & love to make it through even the hardest of times.

Many prayers were answered in June 2012, when HOPE was awarded status as a Federally Qualified Heath Center, providing long-term federal funding & a stable foundation from which to expand. Since the early days, HOPE has grown by leaps & bounds, from a team of 4 to 56, from a double-wide trailer to a shining, light-filled facility with not one, but two additional sites. In addition to providing our patients high-quality primary medical care, we now offer behavioral healthcare, dental care, pharmacy services, interpreter services, and the support of a certified application counselor. In the last 12 months-from July 1, 2016 to June 30, 2017-we offered a total of 14,285 medical, mental health, and dental visits!

Impact

Please find below a few HOPE's major accomplishments and program highlights from the last year. (More details can be found in the "Programs" portion of our profile.)

Effective CY2017, we received our largest ever award from HRSA of $1,772,551.00 for ongoing base funding as a Federally Qualified Health Center (FQHC). These vital funds help to make up the difference between our cost to serve the uninsured and the nominal revenue we bring in from self-pay patients through our discounted Sliding Scale Fee structure. Because of this ongoing support, in response to the needs of our patients and service area, and through special expansion opportunities offered through the ACA, we have grown at a very fast pace in the last few years.

When HOPE first received FQHC status, we had just nine staff. We now have 53! This includes six medical providers,* three mental health providers, two pharmacists, a dentist and a dental hygienist, an outstanding nursing team, four administrators, and invaluable support, reception, and healthcare navigation staff. (*HOPE's CEO & Associate Chief Medical Officer are also licensed medical providers but currently serve in Administrative roles at HOPE.)

This increased capacity has allowed HOPE to serve a growing patient body through a greatly expanded scope of services. In CY2012, HOPE served 1,773 patients through 4,749 encounters. In CY2016, HOPE served 3,399 patients through 12,976 encounters!

One of our major accomplishments in the last year was the launch of our 340B pharmacy on 7/11/2016. The Pharmacy at HOPE Family Health, located at our Sumner North campus, filled 16,705 prescriptions in its very 1st year!

Another major accomplishment has been the launch of our new dental program, the HOPE Salvus Dental Clinic, in January of 2017. Co-located with the Sumner County Health Department in Gallatin, TN, HOPE now offers comprehensive dental services to patients referred internally by HOPE's providers, as well as to patients of Salvus Center, the Sumner and Macon County Health Departments, and as schedules permit, to public patients. In the first six months of the program, we have already provided services through 731 dental visits!

Finally, we are very proud to say that in the last year, we paid off 100% of the overpayment debt discussed in the finance portion of this profile. This debt had threatened our very existence, and we are relieved to be able to redirect a portion of our very modest clinical revenue to building a reserve. (Note: The vast majority of HOPE's funding is dedicated to restricted to the purposes of specific grants and can not be used to enhance long-term sustainability.)

Our primary goals for the current year, taken from our Strategic Plan, include:

1. The referral of new patients to HOPE! We truly have so much to offer, and it is our mission to serve! HOPE's current and future HRSA funding is largely driven by encounter data & a demonstrated need for services. All patients are welcome, regardless of ability to pay. Uninsured patients w/ incomes < 200% of the poverty level are invited to use our Sliding Fee Scale, and most major insurance plans are accepted. You can help us by spreading the word!

2. Donations earmarked for our Reserve. (See Impact Statement above.)

3. Unrestricted Donations. These funds help close the gap between what a medical visit costs HOPE (an average $231.94) & the clinical revenue that is collected (an average of $95.00/visit.) Currently, 23% of HOPE's patient base is uninsured & more than 95% of those fall below 200% of the federal poverty line. While our federal funding is critical to HOPE's survival, it far from covers our operational expense!

Anyone can donate at any time. Most gifts to HOPE come in the mail or are dropped off in person, but you can also give online. HOPE has several donors who have pledged monthly gifts, and you can also designate the program your gift will support. As you explore our profile, we hope you'll be moved to support one of our programs!

HOPE does not place emphasis on the amount donated. We focus on the spirit of the gift. One of our most prized donations came from a couple who are patients of HOPE. With very few resources, they often have difficulty making ends meet. During an office visit, they pulled out $5-four one dollar bills and four quarters. They had "a little extra left over this month" and wanted HOPE to have it! This gift is priceless to us, and we will always remember it. Regardless of the amount you choose to give, lives WILL be blessed with your gift!

Unless otherwise designated, your donation will go to our HOPE Assistance Fund (HAF) & Bridge Programs. HAF offers support to vulnerable patients with a specific medical or humanitarian need which can not be met through other funding streams at HOPE, most often specialty visits and/or advanced testing. The fund can also be used to pay insurance premiums for patients in active treatment for life-threatening conditions, or for food, rent, or utilities for fragile patients who might not otherwise survive extreme temperatures or conditions. The separate HOPE Bridge Program, reserved for the most economically vulnerable patients, can cover internal sliding scale fees for a period of three to six months. Specifically for patients facing recent tragedy, loss, or extreme poverty, the program helps individuals get vital healthcare to regain stability, health, and hope. Most often, this support is provided to families who have lost their sole breadwinner to death or disability or lost their homes to fire or natural disaster.

Thank you. In a world with so much need, YOU have decided to be a blessing.

Most of HOPE's patients come from Macon, Northern Sumner and Trousdale Counties, as well as rural communities along the Southern Kentucky border. Providers new to HOPE consistently reflect that our patients are among the most traumatized they have ever seen. Local statistics reveal a community rocked by economic distress, poverty, chronic disease, work injuries, traffic fatalities, drug and alcohol addiction, and premature death. The following data begins to describe the struggle:

In 2008-2012, Macon County had the
highest incidence of breast cancer in TN, ranked 6th for overall
cancers, 2nd for leukemia and 8th for lung/bronchial
cancers. Trousdale:15th for lung/bronchial & 1st for colon/rectal. (National Cancer Institute,

TN Incidence Rates by County)

Suicides & related hospitalizations in the Upper Cumberland are among the highest in TN. From 2009 to 2014, Macon lost 27 of 23,000 residents to suicide; Trousdale, population 8,000, lost 11. & (TSPN Report Status of Suicide in Tennessee,)

In 2015, Sumner ranked 3rd for Clandestine Meth Lab Seizures. 70 home meth labs in Macon were quarantined. This compares with just 108 for Davidson, pop 679,000. (tn.gov/tbi/article/methamphetamine-prescription-drugs).

As you can see, the need in this region is tremendous. As difficult as the work can be, we are very grateful to have the opportunity to serve here. God has planted us in this place, and it is our calling to stay and care for His people.

Board Chair Statement

To Whom it May Concern,

HOPE would like to thank you for the time you have taken to learn more about our health center. It is both an honor and a privilege to serve as the chairman of the board for this amazing organization, and I personally am deeply thankful for the work the staff of HOPE Family Health does each and every day. HOPE is a unique place that operates selflessly and by faith serving those in our community who need medical, dental and mental healthcare the most. This organization would cease to exist without the loving and faithful contributors, foundations, and supporters who believe in what we do and continue to ensure our existence. We encourage you to contact us today to learn more about how you can become involved in the life-changing work that happens at HOPE Family Health.

HOPE is unique in many ways, but one of the most beautiful ways in which we shine is through the love and grace we show one another as we care for our patients and community. As a faith-­based organization, supporting our staff spiritually is supremely important. Day in and day out, they bear witness to so many really difficult, tragic situations. One provider shared with me that she had 3 patients in 1 day that were diagnosed with cancer, and this is a primary care setting! Praying together is one of the most important things that we do.

The following reflections from our remarkable staff, taken from interviews filmed last year, illustrate our mission and culture beautifully:

HOPE was never a business. It was and continues to be a profound calling. Our call is to treat each patient with love and compassion, to be the the hands, feet, and voice of Christ.

Faith is the essence of HOPE, and our spirituality is at the very heart of the organization. Our mission is a direct response to Jesus’ loving command 'to love your neighbors as yourselves.'

The mission of Hope Family Health is to take care of all
the patients that walk through that door, no matter their color, no matter
their status, no matter how rich they are, no matter who they are, you take
care of them, from top to bottom, head to toe, mind body, soul.

People know when they come to HOPE that, it doesn’t matter where you come from or who you are, you’re gonna be greeted with that smile, and you’re gonna be treated with kindness.

HOPE is a holy place. You can feel the presence of God here as if you’re in a church. You know that His hand is what keeps this place going, and that this is here for His people.

My favorite thing about HOPE is just the love that’s here.
You just have a sense of peace and family. Your problem is everyone else’s problem. They carry your burdens; you carry theirs.

They’re your family. You can get mad at ‘em (laughing). You
laugh together, you cry together, but at the end of the day we’re all still a giant family.

When things are going good, we praise God. When things are
going bad we ask God to just take control and guide HOPE in the direction it needs to go.

There’s no place that I would rather be. This is a completely
different experience than anywhere that I have ever worked.

This is where God has called me to be at, and I love what I
do. I hope that I can be
here until I guess I die! I’ll be here a long time.

We are so blessed to be part of God's story unfolding in this beautiful place. Thank you for considering joining us on the journey.

Because the conditions being treated through this program as so diverse, and the hoped-for health outcomes so varied, it is difficult to project or express universal clinical outcomes.

One overarching measurable goal, however, is to provide more than 20,000 total patient encounters in 2017. We know that there are more patients who need us. And we know there are existing patients who need more of the support that they have begun to receive at HOPE - patients who desperately need to get started in therapy, need help getting medicines, or need dental care, but have been afraid to ask for help anywhere else. Our goal is to provide whole-person care to as many people as possible. Our first step with any patient is building trust. This trust - in HOPE and in God - is the foundation from which all things are possible. As new patients come and as existing patients begin to take advantage of our wider range of resources, we pray that their health overall will improve dramatically.

Long term Success

The long-term definition of success for this program is beautiful and multifaceted, like a prism in its impact on the community at large - better access to health care; a higher level of health literacy, self-care, and self-actualization; better-informed health behaviors; more active and balanced lifestyles; improved health outcomes; increased longevity; and an improved quality of life.

By having caring, compassionate staff, HOPE attempts to bring hope to each life we touch. As we watch lives transformed, and come to love the families of our patients, we are reminded that the fruit of this work moves and is multiplied outside of our walls. We are grateful to help our patients change not only their own lives, but the legacy they leave for their children - a legacy of faith, and hard work, and hope-a conviction that we CAN all choose to make life better, because we have borne witness to the change.

Phone-based patient satisfaction surveys are also regularly conducted by an independent contractor. The feedback from the following question from the Year-End Survey is especially important to us with regards to patients, because "making them partners in the healing process" is a key part of our mission:

"Do you feel like your [HOPE] provider listens to you and do they explain everything where you understand?"

In our 2016 Year-End Medical Patient Survey, 95% of patients answered "Yes - Excellent!" 4% answered "Yes - Good" and just 1% answered "Neutral - Fair". You can not be an effective partner in any effort that you don't understand. Communication & respect are therefore critical. And THAT is a realm in which we appear to be succeeding.

*For a moving success story, keep reading.

Examples of Program Success

Jorge first came to us in March of 2016. Through our Bilingual Patient Navigator, he attested to frequent headaches, feeling weak, urinating frequently & having wounds that would not heal. He was just 38 years old. After checking his blood glucose in the office, Jorge was diagnosed immediately with diabetes; his A1C level was 11.1.{Note: 6.5 or above indicates diabetes.} Right away, we offered education about changes Jorge could make in his diet & lifestyle. This included eliminating his previously heavy consumption of alcohol & soda. He began limiting his carbohydrate intake and taking his medications exactly as prescribed.

At his three mo. follow-up, Jorge looked fantastic. His symptoms had disappeared, and his A1C was an amazing 6.4!!! We were so proud of him for his commitment to improving his health. At six months, he had not only maintained his lifestyle, but lowered his A1C to 6.1. Jorge tells us he is now mentoring his diabetic nephew, a new HOPE patient. HOPE takes flight.

HOPE's BH program, funded through a HRSA Behavioral Health Integration grant, is a vital source of mental care for patients. Our experienced staff include a Program Coordinator, LCSW, LPC, Psych NP, Community Health Coordinator (CHC) & a dedicated Receptionist/MA. Services include medication management, individual therapy, and EMDR. HOPE also offers brief BH consults, I&R, and limited case management through the support of our CHC, who is available at a moment's notice to step in w/ primary care patients at the request of a medical provider or nurse. By offering brief assessments & targeted referrals w/in the primary care setting, we are able to get interested patients on the path to healing w/out their ever having to request a mental health assessment. Prospective patients can be identified, affirmed, introduced to new providers & scheduled all in 1 primary care visit. From July 1, 2016-June 30, 2017, HOPE's BH providers offered care through 2,303 encounters. The results? Remarkable.

As a result of this program, patients in this previously perilously underserved area, will have access to care - many for the very first time - to address the following issues: anxiety, depression, loss and grief, divorce recovery, drug and alcohol addiction, codependency, eating diorders, parenting issues, marital conflict, communication issues, anger management, ADD, ADHD, post-traumatic stress disorder, self-harm, obsessive compulsive disorder, bipolar disorder, and issues of identity and spirituality. For us, it is a huge victory that patients are seeking care. In a region that has been a veritable mental health care desert*, it is a true blessing to serve. Our hearts sing every time we hear our patients telling someone else just how helpful therapy really is. BH is working!

*RWJF's Community Health Rankings 2016 reports that a sole mental health provider serves the entire population of Macon County [~23,000]. This compares w/ 1 provider:780 residents in the state at large.

Long term SuccessActive participation in mental health treatment will carry no more stigma that seeking care for strep throat. Individuals, families, and the community, freed from the fear of being "outed" and the emotional pain of trauma and addiction, will flourish. Fewer and fewer individuals will turn to drugs or alcohol, and more and more will adopt healthy coping mechanisms; learn to set healthy boundaries; seek healthy, edifying relationships; begin to care more tenderly for their bodies, their children and their families; develop rich support networks; and become vibrant members of a thriving community.

Examples of Program SuccessIn May of 2016, Justin came to HOPE to establish as a patient. At his 1st appt., he shared that he had been struggling w/ a meth addiction for 23 yrs. The PCP requested a BHI step-in to provide support, offer resources, and assist w/ scheduling treatment & services. After sharing his story, with his mom by his side, Justin declared he was truly ready for help. Thankfully, he had a wonderful family; as Justin put it, "they only want to see me do better than I have in the past." Justin wanted that too. Our BH Program Coordinator told Justin about a variety of resources for mental health outpatient services, as well as referring him to several detox & rehab facilities. Two weeks later, we were thrilled to learn that Justin had been admitted to a treatment facility. Justin has now been clean and sober since June 5, 2016! Inspired to help others, he has started an NA chapter in Westmoreland. We couldn't be happier to share his story. (*Names changed to protect confidentiality.)

With the support of special HRSA funding, the Pharmacy at HOPE Family Health opened on July 11, 2017. The staff includes a F/T clinical Pharmacist and Director of Pharmacy Services, a second P/T Pharmacist, two Pharmacy Techs, and a Patient Assistance Program Navigator. In its first year, HOPE's Pharmacy filled 16,705 prescriptions! Had these prescriptions had been filled in a retail setting, the cash price to our patients would have been over $923,816.00. Because of our status, however, as a 340B Pharmacy, as well as our regular discounted prices and sliding scale fee program for the uninsured, patients actually paid only $143,941.77-a savings of nearly $800,000.00. The on-site program and the extensive knowledge of our Pharmacists are absolutely invaluable for those without transportation, those with limited incomes, and those with complex pharmaceutical regimens.While our Pharmacy can and does fill many brand name prescritions, many patients are actually eligible for FREE medications through Manufacturer PAPs. Our Prescription Assistance Program therefore remains a vital support to eligible patients needing brand name medications. In the past year (July 1, 2016-June 30, 2017) HOPE's PAP served 241 eligible patients, delivering over $1,325,000* in free pharmacy drugs to HOPE's patients (*wholesale value).

DescriptionThrough a unique partnership with the Salvus Center of Gallatin and with the support of a HRSA Dental and Oral Health Services grant, HOPE was able to expand its scope of services once again, opening the new HOPE Salvus Dental Clinic in January of 2017. Co-located with the Sumner County Health Department in Gallatin, TN, HOPE now offers comprehensive dental services to patientsnreferred internally by HOPE's providers, as well as to patients of Salvus Center, the Sumner and Macon County Health Departments, and as schedules permit, to public patients. Services include dental exams, x-rays, cleanings, deep scaling, sealants, extractions, fillings, dentures, and referrals for root canals and complex oral surgery. In the first six months of the program, we have already provided services through 731 dental visits!

DescriptionHOPE's commitment to the Hispanic community of rural Middle TN is expressed most clearly and profoundly through our decision to hire a full-time interpreter and Bilingual Patient Navigator. Our neighbors include hundreds of tobacco, farm & construction workers, many of whom move through life without any formal social support or any meaningful personal connection to the English-speaking world. This program offers invaluable support to our many Spanish-speaking patients as they seek care at HOPE. Through the entire process-from registration to triage, from labs to treatment plans, our cherished Hispanic patients have the bicultural and bilingual support of a qualified interpreter. In CY2016, our Bilingual Patient Navigator served 393 Spanish-speaking patients through 911 patient encounters. HOPE's Spanish-speaking patients come to us from great distances, as far as Cookeville, Crossville, and even Pulaski. If that's not a compliment & a testimony of gratitude, we don't know what one is.

CEO Jennifer Dittes brings to HOPE Family Health a lifelong passion for healthcare, a deep faith, a gift for sharing the vision, and strong leadership and communication skills. A native of California, Jenny has called Tennessee home for over 17 years. Jenny spent much of her childhood abroad, and was exposed to a wide range of economic realities and a wealth of diverse cultures at an early age. Though the lifestyle was far from that of her peers in the States, God, and God's love, were always near at hand, and she realized that He would follow her wherever she went! An adventurous traveler, Jenny has seen more of the world than most of us ever will. After graduating cum laude from Newbold College (Bracknell, England) with a B.A. in English and minor in communications, she went on to serve as a volunteer lab and dental assistant in Cameroon, where she acheived fluency in French. Just two short years later, she earned her license as a Physician Assistant from the Kettering College of Medical Arts (Kettering, Ohio), sealing her future in medicine. After practicing for several years in Arizona, Jenny again committed herself to international service, coordinating a health program for Kosovar refugees in rural Southern Albania. It was after this experience that Jenny moved with her husband to his family's home state of Tennessee. She practiced medicine in Westmoreland and Lafayette for four years, and the people stole her heart. It was here, in 2004, that she felt a clear call to open HOPE. As our cofounder and Executive Director, Jenny has built HOPE on a solid foundation of faith, hope, and love. But the greatest of these is love. Through even the hardest of times, Jenny held out hope; despite the odds, she persisted.* We give thanks for Jenny's leadership, her heart, her tireless years of dedication, and her profound example of faith.

*To learn more about Jenny's leadership, please see her comments in the Financial section of this profile. Thank you.

Staff

Full Time Staff45

Part Time Staff7

Volunteers0

Contractors3

Retention Rate91%

Plans & Policies

Does the organization have a documented Fundraising Plan?Yes

Does the organization have an approved Strategic Plan?Yes

Number of years Strategic Plan Considers2

When was Strategic Plan adopted?June 2016

In case of a change in leadership, is a Management Succession plan in place?Yes

Experience/BiographyMario Flores, CFO, comes to HOPE with vast experience as a managing accountant for large organizations and corporations, including decades of national-level corporate leadership with Macy's, Inc., as well as other major department stores. His gifts and committment have been absolutely instrumental in HOPE's survival and growth. In the last five years, under Mario's watchful eye and careful supervision, we have survived a near bankrupcy and paid off hundreds of thousands of dollars of debt. At the same time, our annual budget has increased almost exponentially, from $650,000.00 in 2012 to a current annual budget of over $4,700,000. We know, without question, that very few individuals have the capacity to navigate such difficult waters, much less manage such a multi-dimensional, ever-evolving annual budget. Mario's expertise, leadership, attention to detail and dedication to excellence have now allowed HOPE to acheive five years of unqualified financial audits. In addition to his masterful financial leadership, we are grateful for Mario's presence on our Administrative Team for another reason entirely. As a native Spanish-speaker, El Salvadoran, and immigrant to our nation, Mario represents and exemplifies the hopes and dreams of so many of our precious Hispanic patients. He understands where they have been, and his role as our CFO at HOPE serves as a shining testimony to the deep respect HOPE holds for the dignity of ALL of God's people.

Experience/BiographyDana Henderson, FNP-C, serves as HOPE's Associate Chief Medical Officer. One of our first providers, Dana joined our team in 2007. Her story, also, is one of remarkable strength and leadership. A native of Macon County, Dana and her family are well known and beloved in the community. A top student in her class, Dana was determined to study medicine. In a local economy dominated by tobacco, agricultural, and factory jobs, and in a community where most women marry and start families at a very young age, Dana took a decidedly different path. While she did marry her highschool sweetheart, she never set aside her ambition to become a nurse. Although many women in the area pursue work as a medical assistant, Certified Nursing Assistant or even LPN, precious few seek a four-year degree. Dana's sights were set even higher. After earning her Bachelors of Nursing from Western Kentucky University, she went on to earn her Masters of Science in Nursing at Vanderbilt, gaining her certification as a Family Nurse Practitioner in 2000. Before coming to HOPE, Dana practiced at the Rural Health Clinic in Red Boiling Springs and at a private practice in Lafayette for several years. A talented nurse and a committed Christian, her skill and heart had gained her a serious reputation for mercy. People who couldn't afford traditional medical care were lining up in her driveway. She couldn't and wouldn't turn them away. Her heart and HOPE's mission fit like a glove. And through years of hardship, she stood true. This past year Dana celebrated ten years serving as a Senior Staff member at HOPE. Dana's love of the community, her innate understanding of the local culture, and her brilliance in the academic sphere allow her to navigate effortlessly between worlds; she is at once her patient's best advocate, their most loyal accountability partner, and a fierce defender of our mission. As the day-to-day supervisor of all clinical operations, she serves as an expert resource to our staff, manages all clinical compliance efforts, QAQI, helped to launch our Pharmacy, and is currently leading HOPE's efforts to achieve Patient Centered Medical Home.

Experience/BiographyDr. Bien Samson, M.D. serves as HOPE's Medical Director. A native of the Philippines, Dr. Samson completed his Doctor of Medicine at the University of East Ramon Magsaysay Memorial Medical Center in May of 1964. He later went on to complete his General Surgery Residency at the Medical College of Pennsylvania, recieving a Surgical Oncology Fellowship at the Fox Chase Cancer Center in 1973. After serving as the Director of the Cancer Detection Program at Fox Chase for two decades, Dr. Samson made his way to Tennessee, which he has called home now for over twenty years. HOPE is truly blessed to have Dr. Samson as our Medical Director. He brings to HOPE a wealth of medical experience as a Board Certified Medical Doctor, a Certified Medical Director, general practic surgeon, and seasoned hospital administrator. An active member of the local Rotary Club, Dr. Samson is always on the lookout for ways to serve the community, and never shies away from addressing challenging cases at HOPE. He is moved but never shaken by the odds, and has persistently advocated for HOPE's patients through the years, going so far as to perform surgeries for uninsured patients and staff.

Experience/BiographyAngela Harper, HOPE's Director of Human Resources, is a shining example of the gems we find from within. When Angela was first hired, she already had six years of experience as medical receptionist and six in billing. Remarkably, she had already used an electronic medical record for years, a tremendous asset for a tiny practice eager to cede reliance on mounting paper charts. On HOPE's staff since day one, Angela started as a Billing Specialist, and was quickly promoted to the position of Office Manager. In the years following HOPE's designation as a Federally Qualified Health Center in 2012, interviewing, hiring, and orienting new staff; and managing provider credentialling, scheduling, and support staff had become an all-consuming effort for HOPE's CEO. The time had come. HOPE needed a Director of Human Resources. With her easy manner, even-keeled personality, institutional knowledge, discreet nature, dedication to the mission and clear command of the task at hand, Angela was the obvious choice. In addition to managing the traditional duties associated with HR, Angela also serves as the direct supervisor to all of HOPE's receptionists, as well as our Bilingual Patient Navigator. We are ever so grateful to have her steady hand and heart on the team.

This last Easter, CEO Jenny Dittes shared the following story of HOPE's renewal and transformation. We believe that this testimony will help you to understand HOPE's financial history and the obstacles we have overcome, as well as the basis of our current needs. Enjoy!

HOPE Family Health opened in January, 2005, in a double-wide trailer in Macon County, on the outskirts of the small town of Westmoreland. Although the startup phase was challenging, the crisis which occurred several years later tested us to the very core.

In March of 2009, a payor audit revealed that for almost two years, HOPE had been using the wrong codes for several billable services. This had resulted in an overpayment to HOPE by insurance companies of $757,229. Our attorney told us we were obligated to self-report to all 15 insurance companies involved, and pay the money back.

In April of 2009, HOPE sent the letters of voluntary disclosure, offering to set up repayment agreements. The process of negotiating these agreements took well over a year, and was excruciating for me. I hate to owe even $20, let alone $757,000! Even worse, there was no money available to re-pay the debt.

And it only got worse. In August of 2010, Amerigroup canceled its contract with HOPE. A year later, AmeriChoice followed suit. These two contracts represented 25% of our active patients, and about 1/3 of our clinical revenue.

We began cutting costs. We laid off three of our 12 staff. On multiple occasions, several of our board members loaned HOPE money. I cut my own salary. Several others volunteered rather than accepting a pay check. One staff member deferred her paychecks for months in a row. We also applied to become a Federally Qualified Health Center, submitting the application in December of 2010.

In addition, in 2010, we asked Baptist Healing Trust, Memorial Foundation, and St. Thomas Hospital for special “sustainability funding.” BHT gave $27,000, Memorial gave $50,000, and St. Thomas initially gave $20,000, which kept us from bankruptcy through mid-2011.

I remember many, many times, during the years between 2009 and 2012, our small group of staff holding hands in a circle the day before payroll was due, praying we’d have enough in the account. On one of those occasions, when the deficit was worse than usual, my cell phone rang almost immediately after the prayer was over. It was Mr. Elliott, who had returned my call to say the Memorial Foundation would be glad to release the next $25,000 of our grant funding a month early! On the thank-you card we sent to Mr. Elliott, one of our Medical Assistants wrote, “God works in awesome ways. I thank him for placing us in your heart at our time of need. I cry tears of joy in thanksgiving of your gift and support of our mission.”

There is not enough space to recount the beautiful, painful, harrowing and miraculous experience of those three years from 2009 to 2012. It was a daily decision to keep going against all the odds, to live in a state of complete uncertainty but to keep believing, to choose the hard path forward rather than the easy path of giving up.

HOPE did eventually settle the debt at 47% of the original amount owed, signing extended repayment agreements totaling $323,000 with the five largest insurance companies involved (AmeriChoice, Amerigroup, Medicare, BlueCross BlueShield and BlueCare), and paying in full the 10 smaller insurance companies.

In 2011, recognizing that HOPE was not sustainable long-term, the board voted to seek merger with another nonprofit. In December 2011, we accepted an offer of acquisition by St. Thomas Health.

However, in June of 2012, when the acquisition was all but finalized, HOPE found out that it was the recipient of the FQHC grant award initially applied for in 2010! Subsequently, both organizations pulled back from the acquisition in order to allow HOPE to accept the award.

As I write this in April of 2017, much has changed!

In January of this year, HOPE made the last payment of its insurance overpayment debt – a moment of great celebration! In addition, HOPE has been able to re-contract with Amerigroup, effective December, 2013, and with AmeriChoice (now United Healthcare Community Plan), effective January 2016.

This turnaround has allowed us to achieve our mission in ways which seemed un-imaginable just a few years ago. It has multiplied many times over the number of patients we can serve, as well as our geographic reach. It has made us a major employer in this rural, economically depressed area. For me, this experience of building our HOPE family and introducing so many new staff to HOPE’s unique, welcoming organizational culture has been a particular source of joy. I am also incredibly proud of the growing number of services HOPE is able to offer, making comprehensive, whole-person care more and more of a reality.

Related Information

"Women in Tennessee are in the middle of a health crisis. What are YOU going to do?"
Dr. Stephaine Walker's call to action followed the launch of the TN Women's Health Report Card, which showed some clear areas of progress since the previous snapshot of women's health in our state, but also a number of areas in which there is still significant work to be done. While we are getting more mammograms and have significantly decreased our rates of breast and lung cancers, for example, cervical cancer rates have increased, and 42% of Tennessee's women have high blood pressure. Almost 1 in 5 of us smoked while we were pregnant, and 1 in 3 of us are obese. African American women experience striking disparities in rates of breast cancer, STD contraction, and infant mortality.
The full 2013 report can be accessed through the link below. Read carefully, and decide what YOU are going to do to improve the health of women in Tennessee.

The dramatic achievements of public health in the 20th century have improved our quality of life in a myriad of ways, including an increase in life expectancy, worldwide reduction of infant and child mortality rates, and the elimination or reduction of many communicable diseases. In Middle Tennessee, improvements in preventive medicine and advanced medical technology have resulted in increased life expectancy and improved health for many residents. However, significant health disparities exist in our region, resulting in poor health status often related to economic status, race, and/or gender.

“I’ve never shared my story with anybody.” -- The first step toward recovery can be the most difficult. The ability to engage in productive activities, to find relationships with other people fulfilling, and to adapt to change and cope with adversity are each vital to enjoying a happy and healthy life. But each of these facilities can be significantly impaired by mental health disorders. A mental health diagnosis should not define who a person is, or what a person can achieve through treatment and support. Middle Tennessee nonprofit organizations are ready to help make that first step toward good health a little easier.

In Tennessee, gang presence has been on the rise since the late 1980s and early 1990s, when gangs first made a concerted push into the state. Since 2011, police have identified at least 5,000 gang members in Davidson County, and gang-related crimes have increased by 25%. Meanwhile, cities with 50,000 or fewer inhabitants have seen gang-related crimes triple in frequency nationally since 2005.

The United States stands out among nations as a melting pot of cultures and ethnicities. Demographers predict that by 2050, no single majority group will exist in the United States. Diversity is a key part of Middle Tennessee’s past, present and future. Nashville, especially, is a model of the American "melting pot," with an active Native American population, thriving Hispanic community and growing Middle Eastern and Asian presence. Different cultures, religions, ideas and customs come together harmoniously in Music City.